Petitioner has practiced in various courts of the State of New York, including*

( Max. 120 char. )

3.

Petitioner is a member of a good standing of

* the bar of

( Max. 120 char. )

4.

Attorney registration number(s)

State:

NY

CT

VT

YesNo

Education

Petitioner attended

*
Law School:

*
Degree:

*
Year:

Additional Information

*
Barcode:

(first and last initial and last 4 digits of your Social Security Number)

*
Petitioner's Email:

*
Petitioner's Email(confirm):

*
Office Telephone Number:

*
Fax:

Alternate (Office) Email:

Alternate (Office) Email(confirm):

*
Select the location more convenient for you:

BrooklynCentral Islip

*
Suggested Date of Admission:

Admissions are held in each of the Courthouses according to the following schedule:Brooklyn, 718-613-2285,- every Friday morningCentral Islip, 631-712-6030, - third Wednesday of every month at 2:00 p.m.